Findings

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Evidence found and GRADE certainty

1,127 questions · 1,590 findings · 132 reviews · Oral Health

No studies found 189 · 11.9%GRADE not reported 1,166 · 73.3%Very low 130 · 8.2%Low 69 · 4.3%Moderate 25 · 1.6%High 11 · 0.7%

Genetically predicted DMFS (dental caries) vs Reference (1-SD lower genetically predicted DMFS)

Femoral neck bone mineral density (FN-BMD) · European-ancestry adults

Genetically predicted dental caries (DMFS) had no causal effect on femoral neck BMD.

1 finding from 1 review

Genetically predicted periodontitis vs Lower genetically predicted periodontitis liability

Femur fracture · European-ancestry adults

Genetically predicted periodontitis had no causal effect on fracture of femur (multivariable MR, OR 1.034).

2 findings from 1 review

Higher drinking-water fluoride exposure vs Null / lowest drinking-water fluoride exposure (reference)

Hip/femoral bone mineral density (BMD) · general population

Hip BMD increased with fluoride in both sexes (linearly in males, non-linearly above ~1.2 mg/L in females); no numeric MD reported in text for the main analysis; ungraded.

1 finding from 1 review
  • The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomes
    Long-term / lifetime fluoride exposure · General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride · Both sexes, main dose-response
    Hip BMD increased in both sexes, linearly in males and non-linearly (starting above 1.2 mg/L) in females (no numeric MD reported in text for main analysis)
    Studies not reported
    GRADE not reported

Genetically predicted periodontitis vs Lower genetically predicted periodontitis liability

Osteoporosis · European-ancestry adults

Genetically predicted periodontitis had no causal effect on osteoporosis (multivariable MR, OR 1.000).

2 findings from 1 review

Genetically predicted DMFS (dental caries) vs Without dental caries (lower genetic liability)

Lacunar stroke · European-ancestry adults

Genetically predicted dental caries showed no significant causal association with lacunar stroke (ungraded MR).

1 finding from 1 review

Genetically predicted periodontitis vs Lower genetically predicted periodontitis liability

Bone mineral density in forearm · European-ancestry adults

Genetically predicted periodontitis had no causal effect on forearm BMD.

1 finding from 1 review

Replacement of the defective restoration vs Repair of the defective restoration

Composite: Preference for replacement over repair - Scenario 8: disruption of occlusal integrity · Dentists managing a defective direct resin composite restoration (posterior occlusal Class I; standardized vignette of a 30-year-old,…

For a defective composite restoration with disruption of occlusal integrity, surveyed dentists most often preferred repair over replacement (pooled RR 0.37; p < 0.001); ungraded.

1 finding from 1 review

Higher drinking-water fluoride exposure vs Null / lowest drinking-water fluoride exposure (reference)

Hip/femoral bone mineral density (BMD) · Females (all ages)

In females (low-to-moderate risk-of-bias studies), hip BMD rose monotonically above ~0.9 mg/L: MD 0.04 g/cm2 (95% CI -0.03-0.12) up to ~2.3 mg/L and 0.09 (-0.09-0.27) at 4.0 mg/L vs null; ungraded.

2 findings from 1 review
  • The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomes
    Long-term / lifetime fluoride exposure · General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride · Females, low-to-moderate risk-of-bias studies: up to ~2.3 mg/L vs null
    MD 0.04 [-0.03, 0.12]
    Studies not reported
    GRADE not reported
  • The association of fluoride exposure with bone density and fracture risk: a dose-response meta-analysis. 2025 All outcomes
    Long-term / lifetime fluoride exposure · General population; 37 observational studies (1944-2024), predominantly North America (USA, Canada) and Northern Europe (Finland, Sweden), plus UK, Poland, Italy, Germany, China, Taiwan, South Korea, Ethiopia; exposure mainly community drinking-water fluoride · Females, low-to-moderate risk-of-bias studies: 4.0 mg/L vs null
    MD 0.09 [-0.09, 0.27]
    Studies not reported
    GRADE not reported

Replacement of the defective restoration vs Repair of the defective restoration

Amalgam: Preference for replacement over repair - Scenario 5: open margin · Dentists managing a defective direct amalgam restoration (posterior occlusal Class I; standardized vignette of a 30-year-old,…

For a defective amalgam restoration with open margin, surveyed dentists most often preferred replacement over repair (pooled RR 5.14; p < 0.001); ungraded.

1 finding from 1 review

Genetically predicted DMFS (dental caries) vs Lower genetically predicted DMFS

Osteoporosis · European GWAS participants

The SVMR Weighted Median interval excluded the null.

3 findings from 1 review

Health expenditure per capita vs Higher vs lower per-capita health expenditure categories

Oral health-related quality of life · people aged 60 years and older living in the community

OHRQoL did not differ significantly across per-capita health-expenditure categories; no pooled estimate was reported in the text (ungraded).

1 finding from 1 review

Country-level edentulism prevalence (Global Burden of Disease) vs Low vs high edentulism prevalence

Oral health-related quality of life · people aged 60 years and older living in the community

OHRQoL did not differ significantly by country-level edentulism prevalence; no pooled estimate was reported in the text (ungraded).

1 finding from 1 review

Genetically predicted periodontitis vs Lower genetically predicted periodontitis liability

Forearm fracture · European-ancestry adults

Genetically predicted periodontitis had no causal effect on fracture of forearm (multivariable MR, OR 0.995).

2 findings from 1 review

Genetically predicted periodontitis vs Lower genetically predicted periodontitis liability

Femur fracture · European GWAS participants

The SVMR Weighted Median interval included the null.

3 findings from 1 review

Genetically predicted periodontitis vs Lower genetically predicted periodontitis liability

Postmenopausal osteoporosis with pathological fracture · European GWAS participants

The SVMR Weighted Median interval included the null.

3 findings from 1 review